Joseph Cameron Entrekin, PHARMD, CDM
Individual provider Active NPI Pharmacist · Bremen, GA
NPI 1255453296 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255453296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 018340 (GA)
- Practice address
- 116 Buchanan St N
Bremen, GA 30110-1606 - Phone
- (770) 537-2364
- Fax
- (770) 537-3032
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018340 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jones and Clayton Drugs, Inc | Past |
Accepting new patients | |
| Jones and Clayton Drugs, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 018340 | GA | Yes |
Addresses
Primary practice location
116 Buchanan St N
Bremen, GA 30110-1606
Mailing address
501 Valley Run Dr
Bremen, GA 30110-2411
Phone (770) 537-3574
Other providers in Bremen, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.